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Author
Topic: dual therapy experiences (Read 1960 times)

I was diagnosed in 2005 and the forums were a great support for me in my first 3 years. After a while I took some distance from the site as browsing the site daily was having a negative impact on my acceptance of the whole "situation".

But now I am at a point where I need some input from forum members.I've been through several combos and switching has always been because of tolerance issues not resistance. For example I went off Emtricitabine because it worsened my neuropathy, dropped Sustiva because of the brain fog, Atazanavir was heavy on my kidneys (kidney stones) and recently I was taken off Tenofovir also because of my kidneys (protein levels too high).

Dropping the Tenofovir left me with only boosted (ritonavir) Darunavir and Ziagen.My doc then said she was pretty confident that this dual therapy would keep the virus in check. So she offered me the choice to try it and meanwhile she consulted other doctors in her group. The verdict from the group was to play it safe and still add a 3rd drug but the choice was still mine to make.

I was already wary from the start, because we all know the golden standard is to use 3 drugs. I opted to switch to Kivexa and keep using boosted Darunavir.

Long story short: It was a disaster. My neuropathy worsened like never before and I was tired to the point that I could barely function. After 4 weeks I decided I'd had enough and threw the Kivexa out of the window. After consultation with my doc she told me to continue on Ziagen and the boosted Darunavir until we would meet again, which is in 2 weeks.

Now here's the thing: I haven't felt so good in 10 years. No fatigue and neuropathy almost down to zero painwise.

What I would like to know is: are there any people out there who are doing well on dual therapy? And I do mean for over a longer period.

I am aware of the risks in dual therapy and I am sure my doc is too.She says there are no long term studies proving her point but she knows of people who are doing very well on dual therapy.

Virological speaking, tenofovir and Ziagen (abacavir) have a very similar profile.

Looking to a resistance chart, you will find that almost all mutations resistant to one are to the other, so in terms of covering all possible mutations that may occur, you may think that these 2 guys have the same power and same limitations. One of them was more or less redundant, so dropping one should not make a difference.

Your Pi has a very high inibitory index, so mutations are very unlikely to happen, anyway.

Your original therapy (boosted (ritonavir) Darunavir and Ziagen + TNF) was not a 'true' tritherapy, it was more like a 2 +1/10 th therapy...

You are not moving from 3 to 2 , but more likely something like 2.2 ish to 2

I am on a similar combo to you now, boosted darunavir and FTC. I dropped the tenofovir from by combo because I did not like the possible long term side effects. Early days (6 weeks) but all OK so far. And feel less tired.